Evidence map›Paper›PMID 40686741›Full record

ArticleAdvances in radiation oncology2025

Clinical Outcomes After Proton Therapy Reirradiation for Recurrent Malignant Glioma: Analysis From the Prospective Proton Collaborative Group Registry.

Omer Gal, Stephen Mihalcik, Lia M Halasz, John H Chang, C Jake Wang, J Isabelle Choi, Charles B Simone, Carlos E Vargas, Henry K Tsai, Rupesh Kotecha and 1 more

Abstract read
In one paragraph

Article in Advances in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Omer GalDepartment of Radiation Oncology, Miami Cancer Institute, Miami, Florida.
Stephen MihalcikDepartment of Radiation Oncology, Northwestern Medicine Cancer Center Warrenville and Northwestern Medicine Proton Center, Warrenville, Chicago, Illinois.
Lia M HalaszDepartment of Radiation Oncology, University of Washington, Seattle, Washington.
John H ChangDepartment of Radiation Oncology, The Oklahoma Proton Center, Oklahoma City, Oklahoma.
C Jake WangDepartment of Radiation Oncology, Willis-Knighton Proton Therapy Center, Shreveport, Louisiana.
J Isabelle ChoiDepartment of Radiation Oncology, New York Proton Center, New York, New York.
Charles B SimoneDepartment of Radiation Oncology, New York Proton Center, New York, New York.
Carlos E VargasDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona.
Henry K TsaiDepartment of Radiation Oncology, ProCure Proton Therapy Center, Somerset, New Jersey.
Rupesh KotechaDepartment of Radiation Oncology, Miami Cancer Institute, Miami, Florida.
Robert H PressDepartment of Radiation Oncology, Miami Cancer Institute, Miami, Florida.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Optimal treatment for recurrent glioma after prior radiation therapy (RT) is not well established. Proton therapy (PT) is increasingly used for reirradiation (ReRT); however, treatment outcomes, toxicities, and prognostic factors for PT-ReRT remain poorly defined. Methods and Materials: The prospective, multi-institutional Proton Collaborative Group registry was queried for patients with malignant glioma who underwent PT-ReRT between July 2011 and December 2023; only patients with at least one follow-up encounter were included. Overall survival (OS) and progression-free survival were assessed using the Kaplan-Meier method, and Cox proportional hazards regression was used for uni- and multivariable analyses (univariable analysis and multivariable analysis). Results: The study cohort included 143 patients, the median follow-up was 11.2 months, and the median time interval (TI) from prior RT (median 58.5 Gy, IQR, 54-60 Gy) to PT-ReRT (median 44.6 Gy, IQR, 39.4-55.9 Gy) was 42.4 months. Median progression-free survival and OS were 8.1 and 11.2 months, respectively. On univariable analysis, improved OS was associated with oligodendroglioma and astrocytoma histology compared to glioblastoma, TI >60 months, Eastern Cooperative Oncology Group performance status 0, and ReRT dose ≥50 Gy. On multivariable analysis, improved OS remained associated only with oligodendroglioma and TI >60 months. Acute and late grade 3 toxicity occurred in 7% and 4%, respectively. Acute grade 3 toxicity was associated with poor performance status. Incidence of radiographic radiation necrosis was 19%. Conclusions: In the largest series of glioma PT-ReRT reported to date, retreatment was well tolerated with variable outcomes based on clinical prognostic factors. Toxicity rates were similar compared to photon-based literature despite a high median ReRT prescription dose.

Identifiers

PMID40686741
PMCPMC12272415

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.